Provider Demographics
NPI:1881839561
Name:HIRSCH, ELIZABETH CLARA (MS, PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CLARA
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 VLEIGH PL
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3360
Mailing Address - Country:US
Mailing Address - Phone:718-591-9093
Mailing Address - Fax:
Practice Address - Street 1:7740 VLEIGH PL
Practice Address - Street 2:
Practice Address - City:KEW GARDENS HILLS
Practice Address - State:NY
Practice Address - Zip Code:11367-3360
Practice Address - Country:US
Practice Address - Phone:718-591-9093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014312-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics